Clinical presentation and management of penetrating chest trauma

Thoracic injuries account for 20-25% of deaths due to trauma and contribute to 25-50% of the remaining deaths. Approximately 16,000 deaths per year in the United States alone are attributable to chest trauma. The present study was done in Dhaka Medical College Hospital from January 2004 to September 2005. This is one of the specialized Institutes of this country dealing with chest injury. In this series, 50 cases of penetrating chest injury were studied and 12 (Twelve) of them had also associated with blunt chest injury. The highest incidence occurred between the ages of 31 and 50 yrs. Male was predominantly affected by penetrating chest injury i.e. 84%. Homicidal injury was common in rural areas but accidental injury was common in urban area. Injuries by sharp weapon caused all of the homicidal injuries. In 28 cases (56%) showed penetrating chest injury with severe respiratory distress and rest 10 (20%) cases showed penetrating chest injury with hemorrhage from external wounds. Here, 70% cases are managed conservatively with or without I.C Tube drainage. Mean duration of Hospital stay for patient treated conservatively with or without 1C tube thoracostomy was 8 days but in patient with major surgery it was 15.5 days. Range of Hospital stay for conservatively treated patient was (3--8 days) and for patient with major surgery it was (10—16 days). Referred to other centers had due to extra--pulmonary Involvement, after initial resuscitation & I.C. tube thoracostomy. Mortality:-2% for penetrating chest injury.